(1/1584) Failing firefighters: a survey of causes of death and ill-health retirement in serving firefighters in Strathclyde, Scotland from 1985-94.
During the decade beginning 1 January 1985, 887 full-time firefighters, all male, left the service of Strathclyde Fire Brigade (SFB). There were 17 deaths--compared to 64.4 expected in the Scottish male population aged 15-54 years--giving a standardized mortality ratio (SMR) of 26, and 488 ill-health retirements (IHR). None of the deaths was attributable to service, the major causes being: myocardial infarction--five, (expected = 17.3; SMR = 29); cancers--three (colon, kidney and lung) (expected = 13.6; SMR = 22); road traffic accidents--two (expected = 4.17; SMR = 48) and suicide--two (expected = 4.9; SMR = 41). Amalgamating the deaths and IHRs showed that the six most common reasons for IHR were musculoskeletal (n = 202, 40%), ocular (n = 61, 12.1%), 'others' (n = 58, 11.5%), injuries (n = 50, 9.9%), heart disease (n = 48, 9.5%) and mental disorders (n = 45, 8.9%). Over 300 IHRs (over 60%) occurred after 20 or more years service. When the IHRs were subdivided into two quinquennia, there were 203 and 302 in each period. Mean length of service during each quinquennium was 19.4 vs. 21.3 years (p = 0.003) and median length was 21 years in both periods; interquartile range was 12-26 years in the first and 17-27 years in the second period (p = 0.002), but when further broken down into diagnostic categories, the differences were not statistically significant, with the exception of means of IHRs attributed to mental disorders (14.5 vs. 19 years, p = 0.03). (+info)
(2/1584) Dose-loading with hydroxychloroquine improves the rate of response in early, active rheumatoid arthritis: a randomized, double-blind six-week trial with eighteen-week extension.
OBJECTIVE: To investigate the usefulness of hydroxychloroquine (HCQ) dose-loading to increase the percentage of responders or rate of response in treating rheumatoid arthritis (RA). METHODS: Two hundred twelve patients with early RA (mean duration 1.5 years) were enrolled in a 24-week trial. Patients were stabilized with 1,000 mg naproxen/day and then began a 6-week, double-blind trial comparing treatment with HCQ at 400 mg/day (n = 71), 800 mg/day (n = 71), and 1,200 mg/day (n = 66), followed by 18 weeks of open-label HCQ treatment at 400 mg/day. RESULTS: All patients had mild, active disease at the time of initiation of HCQ treatment (31-43% rheumatoid factor positive; no previous disease-modifying antirheumatic drugs; mean swollen joint count 8.6-10.4). Based on the Paulus criteria, response during the 6-week double-blind portion of the study was 47.97%, 57.7%, and 63.6% in the 400 mg/day, 800 mg/day, and 1,200 mg/day groups, respectively (P = 0.052). Discontinuations for adverse events were dose related (3 in the 400 mg/day group, 5 in the 800 mg/day group, 6 in the 1,200 mg/day group). Most involved the gastrointestinal (GI) system, with the background naproxen treatment possibly contributing. Ocular abnormalities occurred in 17 of 212 patients (8%) but were not dose related. CONCLUSION: Dose-loading with HCQ increased the degree of response at 6 weeks in this group of patients with early, predominantly seronegative RA. Adverse GI events were dose related, while adverse ocular events were not. (+info)
(3/1584) Histologic analysis of photochemical lesions produced in rhesus retina by short-wave-length light.
The photopathology of retinal lesions produced by extended exposure (1000 sec) to low corneal power levels (62 microW) of blue light (441 nm) was investigated by light microscopy in 20 rhesus eyes over an interval ranging from 1 hr to 90 days after exposure. Results indicate a nonthermal type of photochemical lesion originating in the retinal pigment epithelium and leading to a histological response with hypopigmentation which requires 48 hr to appear. This type of lesion helps to explain solar retinitis and eclipse blindness and has significance for aging and degenerative changes in the retina. (+info)
(4/1584) Disrupted retinal development in the embryonic belly spot and tail mutant mouse.
The Belly spot and tail (Bst) semidominant mutation, mapped to mouse Chromosome 16, leads to developmental defects of the eye, skeleton, and coat pigmentation. In the eye, the mutant phenotype is characterized by the presence of retinal colobomas, a paucity of retinal ganglion cells, and axon misrouting. The severity of defects in the Bst/+ retina is variable among individuals and is often asymmetric. In order to determine the role of the Bst locus during retinal morphogenesis, we searched for the earliest observable defects in the developing eye. We examined the retinas of Bst/+ and +/+ littermates from embryonic day 9.5 (E9.5) through E13.5 and measured retinal size, cell density, cell death, mitotic index, and cell birth index. We have found that development of the Bst/+ retina is notably dilatory by as early as E10.5. The affected retinas are smaller than their wildtype counterparts, and optic fissure fusion is delayed. In the mutant, there is a marked lag in the exit of retinal cells from the mitotic cycle, even though there are no observable differences in the rate of cellular proliferation or cell death between the two groups. We hypothesize that Bst regulates retinal cell differentiation and that variability of structural defects in the mutant, such as those affecting optic fissure fusion, is a reflection of the extent of developmental delay brought about by the Bst mutation. (+info)
(5/1584) Vitrectomy in 125 eyes with diabetic vitreous haemorrhage.
A total of 125 consecutive eyes, all registered blind with diabetic vitreous haemorrhage, underwent pars plana vitrectomy with the vitrophage. Sixty-six per cent experienced some improvement in their visual acuity; 24 per cent were unchanged and 10 per cent were worse postoperatively. The major surgical complication was controllable haemorrhage (23 per cent). No retinal dialysis occurred. Significant postoperative complications were transient (71 per cent) and persistent (11 per cent) corneal oedema, early (8 per cent) and late (13 per cent) vitreous haemorrhage, transient (30 per cent) and persistent (6 per cent) rise in intraocular pressure, and rubeosis iridis (5 per cent). (+info)
(6/1584) Perifoveal vascular leakage and macular oedema after intracapsular cataract extraction.
Perifoveal capillary leakage of fluorescein was demonstrated in 60 per cent of 50 eyes when angiography was performed two weeks after cataract extraction. Repeat angiography six weeks postoperatively in 17 eyes demonstrated persistence of already established leakage in 11 of 12 eyes and no new leakage in five eyes previously negative. Cystoid macular oedema with visual acuity of less than 20/40 six weeks postoperatively occurred in five eyes (10 per cent). Eyes of patients with vascular disease and those patients of 60 years or older were found to have altered vascular permeability significantly more frequently. Inflammation was no more severe or prevalent in those patients who demonstrated leakage and no inflammation was clinically apparent in 10 of 11 eyes demonstrating dye leakage six weeks postoperatively. We conclude that the constitutional factors of age and vascular disease are of prime importance in causing altered vascular permeability in the early postoperative period after cataract extraction; factors causing sustained leakage with reduction of visual acuity were not demonstrated. (+info)
(7/1584) A prospective study of xenon arc photocoagulation for central retinal vein occlusion.
Twenty patients with central retinal vein occlusion were randomly divided into two groups in a prospective study to evaluate the effects of xenon are photocoagulation in central retinal vein occlusion. The patients in one group were treated with 360 degrees scatter xenon photocoagulation and the others received no treatment. The average follow-up was 18 months. There were no cases of rubeosis or neovascular glaucoma in the treated group. Two patients in the untreated group developed rubeosis with subsequent neovascular glaucoma. There was no significant difference in the visual prognosis or in fundus neovascularization between the groups. (+info)
(8/1584) Comparison of PCR, virus isolation, and indirect fluorescent antibody staining in the detection of naturally occurring feline herpesvirus infections.
Cats with clinical signs suggestive of ocular infection with feline herpesvirus type 1 (FHV 1) and cats without such signs were assayed by 3 methods to detect FHV. Comparison of polymerase chain reaction (PCR), virus isolation, and indirect fluorescent antibody staining techniques for the detection of FHV demonstrated higher sensitivity of PCR in detecting this common infectious agent of cats. Compared with PCR, sensitivity and specificity for virus isolation was 49% and 100%, respectively, and those of indirect immunofluorescence were 29% and 96%, respectively. FHV was detected in 13.7% of client-owned cats with conjunctivitis and in 31% of shelter cats with no ocular signs. The use of FHV PCR as a diagnostic test for FHV-associated disease is limited because of the occurrence of healthy carriers. (+info)